Outline

Background

Tuberculosis (TB) has infected one third of the world's population and grounds foremost death from a single infectious agent. It causes 25% of avoidable adult deaths world-wide [Ref.Â 1] and more serious in the developing world, where 95% of cases occur. 61% of aged 15- 49 years and 45% of the total population is infected with TB. Those infected with bacilli, 45,000-50,000 people developing the disease annually. At least 20,000 of who have pulmonary TB, (approx.) 16,000 people die each year. The emergence of multi-drug-resistant bacilli is terrifying the public health concern authorities. Multi-drug resistance is resistant to at least rifampicine and isoniazide [Ref.Â 2]. The Government of Nepal, under a high priority plan, is providing anti-tuberculosis treatment (ATT) regimen of first line, consultation and investigation free of charge through WHO supported programme. Still, the cure/completion rate has revealed 49% except in certain directly observed treatment service (DOTS) centres whereas the target was 85% [Ref.Â 3]. The health consumers are potentially important to evaluate the providers services [Ref.Â 4] and it is generally assumed that satisfied individuals are more likely to co-operate with medical recommendations regarding future visits and therapeutic regimen [Ref.Â 5].

Method

A cross-sectional survey study was conducted at the National Tuberculosis Centre (NTC), the main centre in the Himalayan Kingdom of Nepal to assess whether cure rate was correlated to patients satisfaction with health care service and care provider. The TB patients who visited the centre more than 4 times for follow-up and were on ATT regimen were selected randomly. A total of 153 patients were interviewed using mainly structured and a few open-ended questionnaire regarding service provider and services.

Results

Among the patients 79.7% of them were found to be satisfied. Descriptive finding was consistent with other studies that tuberculosis was widely spread among people having lower economic status, larger family size and lower education where majority (62%) subjects found to be males. No significant correlation between satisfaction and age, family income and number of dependants was found. Stepwise multiple regression result revealed-quality of care (β=2.979, p=0.0034) and personality traits found to be positively (β=5.089, p≤0.0001) correlated. The variables were explained positively for physical environment (β=0.2733, p≤0 .0001) followed by efficacy (β=0.2085, p=0.0471) and cost of supportive drugs (β=0.1369, p=0.0329) respectively. (note: as positive response weighted '1' and negative '2' in questionnaire that were dichotomous forms, the interpretation is being interpreted reversibly).

Recommendation

In order to improve the outcome, the study suggested that management should improve the areas of personality traits, cost of supportive drugs and physical environment in order to enhance satisfaction of patients in the future.

Thanks

The authors express sincere thank towards Deutsche-Nepalische Hilfsgemeinschaft e.V., Stuttgart, Germany and Department of Technical and Economic Cooperation of Thailand for funding the study, and Dr. DS Bam, MD and Dr. NP K.C., MD, National Tuberculosis Centre in Nepal for extending their genuine cooperation for documents and coordination during the survey.